STATEMENT OF SENATOR EDWARD M. KENNEDY ON THE ROLE OF STATES IN KEEPING AMERICANS HEALTHY United States Senate Health, Education, Labor and Pensions Committee Hearing

(As Entered into the Record) The nation is facing a worsening health care crisis that demands our immediate attention. As a nation, we spend two trillion dollars a year on care, yet 1 in 2 Americans suffer from chronic diseases that decrease quality of life and increase health costs. Estimates indicate that close to 200 million Americans alive today will have a chronic illness, and that 1 in 4 dollars will soon be spent on health care. Without basic reform, the burden and the cost of treating these chronic conditions will not be sustainable for future generations.

In order to end this crisis, we need to deal with the factors that lead to the development of chronic disease. Poor diet, physical inactivity, smoking, and alcohol use account for 38% of deaths related to chronic disease among Americans. In particular, the lack of good nutrition and the lack of exercise have led to unprecedented increases in the rates of obesity. About 1 in 3 adults and a staggering 1 in 6 children and adolescents in the United States are obese, and are therefore at increased risk of diabetes, heart disease and other chronic conditions.

Tobacco use leads to conditions such as lung cancer, chronic obstructive pulmonary disease and heart disease, which are estimated to cost Fortune 500 companies $157 billion each year. Many factors lead to chronic disease, but it is estimated that 75% of health care expenditures associated with these conditions are preventable. Prevention and early detection of such diseases is obviously a critical aspect of health reform. 100,000 lives could be saved each year through the use of 5 basic services that include taking daily aspirin, putting an end to smoking, screening for colorectal disease and breast cancer, and immunization for influenza.

Early detection of mental health and substance use disorders will lead to reduced symptoms and enhanced quality of life. For every dollar spent on initiatives to increase physical activity, improve nutrition and prevent smoking, a total of $5.60 can be saved in health costs. Even though a great deal is known about the power of prevention, less than 5% of all health expenditures are spent on prevention. Prevention initiatives also need to address economic, social and physical issues that often make it difficult for people to make healthy choices.

Limited access to healthy food and neighborhoods that are not conducive to physical activity can prevent Americans from making healthy choices, especially in low income and minority communities that suffer a disproportionate burden of chronic disease and are less likely to have preventive services available. By providing such services, we can significantly improve the health of Americans and significantly reduce health costs. Many states are exploring a number of innovative prevention initiatives to combat the effects of chronic illness on their residents. In Massachusetts, the combined cost of treating chronic diseases and the loss in productivity is $34 billion a year.

In response, the Massachusetts Office of Health and Human Services initiated the “Mass In Motion,” a multi-faceted program that includes regulations to promote healthy eating and physical activity, grants to cities and towns to make wellness initiatives a priority, and a new website to give residents advice on how to make healthy eating and physical activity part of their daily lives. This is one of the many important initiatives we will hear about today that focus on reducing the burden of chronic disease on our people. We look forward to hearing about those prevention initiatives as we work on health reform. Chronic disease can affect all Americans, and we need to focus on the steps we know will work best.

The power of prevention is an essential element of health reform—the best way to address the unsustainable increase in health costs related to chronic conditions is to prevent the conditions in the first place. I commend Senator Harkin for chairing this important hearing and for emphasizing that prevention must be one of the principal pillars of overall health reform.

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